А.А. MOROSHEK, M.V. BURMISTROV, A.I. IVANOV, E.I. SIGAL, V.Yu. MURAVYOV

Tatarstan Cancer Center, 29 Sibirsky Trakt St., Kazan, Russian Federation

Moroshek A.A. — Cand. Med. Sc., Oncologist, Department of Development and Adoption of Innovative Cancer Treatment and Prevention Modes, tel. +7-960-055-94-49, e-mail: anton.moroshek@mail.ru

Burmistrov M.V. — D. Med. Sc., oncologist, 2^nd Surgical Thoracic Department, tel. +7-917-869-53-07, e-mail: burma71@mail.ru

Ivanov A.I. — Cand. Med. Sc., endoscopist, Department of Endoscopy, tel. +7-917-261-92-51, e-mail: a.i.ivanov@inbox.ru

Sigal E.I. — D. Med. Sc., Head of 2^nd Surgical Thoracic Department, tel. +7-903-388-85-95, e-mail: sigal_e@mail.ru

Muravyov V.Yu. — D. Med. Sc., Professor, Head of the Department of Endoscopy, tel. +7-987-296-85-03, e-mail: vumurav@inbox.ru

The objectives of the study were to assess the role of complaints of dysphagia and radiographic contrast study in the diagnosis of peptic strictures of the esophagus (PS) in patients with GERD and to prove the feasibility of an integrated therapeutic algorithm that includes antireflux surgery as an essential component. The article presents the results of survey of 104 patients with PS. In the diagnostic phase, we used endoscopy and radiographic contrast study, at the treatment phase — PPI therapy, esophageal dilation and antireflux surgery. In patients with GERD, complaints of dysphagia show moderate sensitivity (62.5%; 95% CI 52.4-77.8%) and high specificity (93.7%; 95% CI 91.7-95.3%), radiographic contrast study — moderate sensitivity (68.3%; 95% CI 58.4-77.1%) and high specificity (99.7%; 95% CI 99.0-99.97%). The comprehensive therapeutic approach, including antireflux operation, is highly efficient (percentage of excellent and satisfactory (both immediate and long-term) results is 84.6% (95% CI 76.2-90.9%) and relatively safe (frequency of intraoperative complications is 8.7% (95% CI 4-15.8%), severe early postoperative complications is 4.8% (95% CI 1. 6-10.9%), frequency of delayed postoperative complications is 3.8% (95% CI 1.1-9.6%). Results of the study allow to make certain conclusions: the absence of dysphagia in case of GERD does not imply the absence of PS; for suspected PS accompanied with GERD, radiographic contrast study must be performed; an integrated treatment algorithm that includes antireflux surgery as an essential component is desirable for the treatment of PS.

Key words: peptic esophageal strictures, antireflux surgery, complications of GERD, treatment, diagnostic.

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